Dangers of Mixing Vicodin and Alcohol

Vicodin is a Schedule II controlled substance that consists of the opiate medication hydrocodone and the over-the-counter medication acetaminophen. Hydrocodone is a central nervous system depressant drug that belongs to the same class of drugs as familiar drugs like oxycodone, morphine, heroin, etc., and its presence in Vicodin accounts for its classification as a controlled substance. The primary medicinal use of Vicodin is for the control of chronic pain or acute pain associated with surgery.

How Does Vicodin Work?

Vicodin’s primary mechanism of action relates to its ability to attach to specialized neurons in the brain that are involved in a number of functions, including the suppression of pain and maintenance of vital functions. These neurons are specialized for neurotransmitters, such as enkephalins and endorphins, that are often referred to as endogenous opiates due to their similar chemical structure and mechanism of action to opiate drugs. Its other effects include:

  • Feelings of euphoria.
  • Sedation and relaxation.
  • Decreases in a number of bodily functions, including breathing rate, heart rate, and blood pressure.
  • Decreases in cognitive abilities that primarily affect the speed of thought, rational or logical thinking processes, attention, and memory.
  • Side effects, such as nausea, vomiting, constipation, jitteriness, etc.
  • A significant potential for the development of physical dependence in individuals who use the drug on a regular basis for more than a few weeks.

Vicodin is one of many prescription narcotic medications that is associated with the rise of prescription drug abuse in the United States. All of the drugs classified as opiate or narcotic drugs have a high potential for abuse due to their ability to relax individuals, result in euphoric states, and produce physical dependence.

How Does Alcohol Work?

Alcohol is also a central nervous system depressant that reduces activity of the neurons in the brain and spinal cord. Alcohol is the most abused drug in the United States, accounting for the majority of substance use disorder diagnoses that occur. Alcohol is often a primary substance of abuse, but other substances are abused along with it, including opiate drugs, stimulants, cannabis products, hallucinogens, etc.

Alcohol’s major mechanism of action primarily occurs as a result of its ability to increase the actions of the inhibitory neurotransmitter gamma-aminobutyric acid (GABA) and to decrease the functions of the excitatory neurotransmitter N-methyl-D-aspirate (NDMA).

Alcohol has a number of similar effects to Vicodin that include:

  • At low doses feelings, general wellbeing, relaxation, and euphoria
  • At moderate to higher doses, sedation, lethargy, and slowed reaction times
  • Decreased heart rate, blood pressure, and rate of breathing
  • Issues with thinking, such as problems with attention, disinhibition, decreased judgment, slowed thinking processes, and memory problems
  • The potential to develop physical dependence in individuals who chronically drink moderate to high levels of alcohol

Mixing Alcohol and Vicodin

man taking vicodin pills with alcoholIndividuals who abuse one substance will also often tend to engage in polysubstance abuse (using more than one substance at a time). There are number of reasons for this, depending on the substances being used. For instance, using two different central nervous system depressants results in an exacerbation of their euphoric effects.

Effects of Mixing Vicodin and Alcohol

Mixing any drugs of abuse is a dangerous practice. According to Concepts of Chemical Dependency, mixing drugs is problematic for a variety of reasons.

  • Mixing drugs can lead to an enhancement of the effects for both drugs. For instance, mixing two central nervous system depressant drugs, such as alcohol and Vicodin, results in an increase in their primary actions of suppressing central nervous system functions. Some of the particular dangers that occur as the natural result of central nervous system depressant reactions when these drugs are mixed include:
  • Impairments in cognition that can lead to increased potential for engaging in impulsive behavior, irrational behavior, or having an accident
  • Decreased motor functioning that includes significantly slowed reaction time and issues with motor coordination
  • Suppressed breathing
  • Suppressed heart rate
  • Suppressed functioning of other organs
  • Suppression of neuronal activity in areas of the brain stem that control life-sustaining functions, such as breathing and heart
  • Increased risk of coma
  • The potential for organ damage due to a lack of oxygen
  • The potential for overdose effects
  • Individuals who mix drugs run the risk of an increased risk for overdose from either drug because of the above enhancement affect. Moreover, individuals may lose track of how much alcohol or Vicodin they have consumed when under the influence of both drugs. This situation can produce a number of potential risks.
  • Obviously, drinking too much alcohol can produce serious effects. As mentioned above, taking too much hydrocodone can result in a number of serious effects. In addition, taking large doses of acetaminophen for lengthy periods is associated with damage to the liver (as is the chronic abuse of alcohol and hydrocodone). It is also probably associated with a number of other deleterious effects, including damage to the cardiovascular system, gastrointestinal system, etc.
  • An increased potential for side effects or unpredictable effects is present when mixing Vicodin and alcohol. Individuals often have personalized reactions to certain drugs, and mixing two different drugs increases the number of potential interactions and side effects that can occur. Often, individuals who use more than one type of drug, even for medicinal purposes, experience interactions that are specific to them. Mixing drugs of abuse (e.g., Vicodin and alcohol) can increase this potential.
  • An increased potential for cross addiction is present. Cross addiction is when the use of one drug makes a person more susceptible to developing a problem with another drug. This issue is somewhat controversial; nonetheless, with similar drugs, there is a tendency for the abuse of one drug to enhance the potential that an individual will abuse another similar drug. An individual who uses Vicodin and begins drinking alcohol may experience enhanced effects from the alcohol and develop an alcohol use disorder in addition to an opiate use disorder.

These acute effects can result in a number of potential dangers that include both physical symptoms and issues with relationships. For instance, an increased potential to overdose on Vicodin or alcohol is obviously associated with increased potential to suffer brain damage, other physical damage, or even death. Issues with cognition and motor functioning can result in potentially serious accidents. Issues with poor judgment can lead to long-term consequences (e.g., engaging in risky behaviors such as unprotected sex) and affect personal or professional relationships.

Long-Term Effects of Mixing Drugs and Alcohol

A number of professional sources discuss some long-term effects that may occur as a result of combining drugs like alcohol and Vicodin:

  • Issues with one’s occupation or education
  • Detrimental effects to long-lasting personal commitments or obligations, such as obligations to one’s spouse, children, friends, professional contacts, etc.
  • Neglecting self-care, such as having poor dietary habits, poor dental care, etc.
  • Increased potential for long-term damage to the body that can include damage to the cardiovascular system, the liver and kidneys, the gastrointestinal system and the central nervous system (brain and spinal cord)
  • An increased potential for physical harm due to being involved in accidents, as a result of poor judgment, or from being involved in potentially criminal activities
  • An exacerbation of psychological problems that can include issues with depression and anxiety, an increased potential to develop a formal mental health disorder, and an increased potential to develop issues with potentially psychotic behavior
  • The development of physical dependence to one or both drugs
  • The development of a substance use disorder related to one or both drugs

Signs of Polysubstance Abuse

The formal instructions that are both given to patients who use medications like Vicodin strongly recommend that the individual not drink alcohol when taking the drug. The knowledge that a person is drinking alcohol and taking Vicodin is enough to warrant suspicion that the person is abusing one or both drugs.

Other signs that suggest abuse include:

  • Becoming extremely intoxicated as a result of drinking a relatively small amount of alcohol
  • Smelling like alcohol or engaging in behaviors that are associated with alcohol use, such as attending bars, parties, drinking alcohol with friends, etc., while taking Vicodin
  • The appearance of flulike symptoms frequently
  • Obtaining Vicodin illegally or attempting to get multiple prescriptions for the drug
  • Finding empty prescription bottles in an individual’s clothing, room, car, etc.
  • Neglecting personal obligations, such as work, family, school, etc., in favor of substance use


The combination of narcotic pain medications such as Vicodin and alcohol is a particularly dangerous but common practice. This represents a serious situation that can have a number of significant short-term and long-term effects on the individual’s physical health, mental functioning, relationships, occupation, and other important areas of life. Individuals who frequently use Vicodin and alcohol should consider becoming involved in a formal treatment program to avoid these issues.

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